小儿常见用药-新北药师公会.ppt

Manufacture’s recommendations Core Principles For Fever Fever in children may be the result of a common viral infection, but could also be an indicator of a more serious bacterial infection or lead to complications such as febrile seizures. Proper management depends in large part on accurate assessment. 支氣管擴張-salbutamol 商品名 : Albuterol syrup 單位 : 0.4mg/ml 60ml/bot 小兒劑量:6 years old，2-5ml , tid；6-14 years old ，5ml tid。 Core Principles For Cold And Cough The treatment of cough and cold symptoms in children younger than 6 years of age is generally supportive with nasal saline, hydration, and humidification. Over-the-counter agents have little proven effectiveness and have been associated with severe adverse effects owing to inadvertent overdoses during parental administration. Case discussion for GER 陳小妹,3個月大,體重6公斤,身高60公分,食物以母奶為主,配方奶為輔,在2個禮拜前發現每次餵時都有牛奶逆流現象。在某次健康檢查中,醫師發現陳小妹體重與上個月體重一樣,經過檢查,醫師診斷為GER, 醫師建議住院治療,經過姿勢調整與餵食習慣改變,陳小妹有嘔吐現象,體重仍然沒有增加,又新增了食道炎這個診斷,醫師認為需要藥物治療介入,請問會如何處置陳小妹的症狀? Case discussion for GER 1.通常第一線使用會從H2RA 開始,若沒改善,再改用PPI 。但從PPI 開始使用是較好的選擇,書上建議每天使用一次omeprazole5mg 泡10ml 的水由口服用。 2.制酸劑使用在兒童的GRE和食道炎的療效並沒有很好的有效數據,大多都是用來緩解症狀用的。如果要再更進一步治療,可使用metoclopramide 0.6 mg (0.1 mg/kg/dose) 口服,在三餐飯前和睡前使用。劑量可隨著病人症狀增減,要嚴密監控副作用,通常治療須持續4個月 Core Principles For GER Gastroesophageal reflux is a common disorder in young infants. Most will require no intervention. Some, however, will require feeding modifications and possibly drug therapy, including acid-suppressing or prokinetic agents. Case discussion for constipation 王小弟,2歲,15公斤,腹痛好幾個禮拜,它幾乎1個禮拜排便1次,都會因為排便疼痛而大哭。王小弟的飲食習慣正常,而且每天都會喝2大杯的牛奶。經過醫師診斷為functional constipation. 請問王小弟的症狀要如何處置? Case discussion for constipation 1.從飲食方面來看,目前沒有相關證據,便秘與牛奶是有直接關聯性 。建議先限制牛奶攝取量。 2.可以先使用Lactulose 1–3 mL/kg/day 可分2次使用,書上建議用 Polyethylene glycol 0.5–1.5 g/kg/day (7.5–15 g). 因為此藥品對兒童效果好,且耐受性高,但1天最大劑量不可超過17g。 Core Principles For Constipation Constipation can be defined by a delay or difficulty in stooling for at least 2 weeks duration. Constipation i